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Cervix-Cytology

Normal cells / non-neoplastic findings

Psammoma bodies

Reviewer: Farnaz Hasteh, M.D., UCSD Medical Center (see Reviewers page)
Revised: 21 December 2010, last major update December 2010
Copyright: (c) 2006-2010, PathologyOutlines.com, Inc.

Definition
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● Microscopic laminated calcified structures, which may be adjacent to normal or malignant cells

Epidemiology
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● Less than 0.001% of pap smears (Adv Anat Pathol 2004;11:250)

Etiology
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● Produced by cross-sectioning the tips of calcified papillary formations

Clinical features
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● Common finding on H&E in various benign and malignant lesions; also in Pap smears
● Either single or in clusters
● Usually associated with benign disorders (Diagn Cytopathol 2002;26:81, Cytojournal 2008 Apr 16;5:7)
● Benign disorders associated with psammoma bodies include adhesions, benign ovarian tumors, cervical polyps, endometriosis, endosalpingiosis (J Reprod Med 2000; 45:526), fallopian tubal cells, IUD (J Reprod Med 1987; 32:147), oral contraceptives, pregnancy, sexually transmitted diseases (DeMay: The Pap Test: Exfoliative Gynecologic Cytology; 2005)
● Benign conditions often have a few associated bland glandular cells versus adherent malignant glandular cells in malignant disorders (Acta Cytol 1991; 35:81)
● Malignant disorders associated with psammoma bodies include ovarian serous carcinoma and ovarian borderline tumors (Arch Pathol Lab Med 1988;112:564); also carcinomas of cervix, endometrium, fallopian tube, peritoneum (Acta Cytol 2010;54:311)
● Recommended to investigate clinically to identify source, especially in women > 45 years, women with abnormal clinical exam, post-menopausal women or worrisome clinical history (Adv Anat Pathol 2004; 11:250)

Prognostic features
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● Even a few atypical glandular cells are suggestive of malignancy, particularly in postmenopausal women (Gynecol Oncol 2006;103:238)

Case reports
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● Granulomatous reaction to aluminum silicate (J Reprod Med 2000; 45:526)

Cytology images
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Without atypical cells

With atypical cells

End of Cervix-cytology > Normal cells / non-neoplastic findings > Psammoma bodies

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